Anti-IL-23 Beats IL-17 in Plaque Psoriasis Save

Lancet reports a head-to-head trial of antibodies against interleukin (IL)-23 and IL-17A in patients with moderate-to-severe psoriasis favored guselkumab with superior PASI 90 responses at week 48 (compared to secukinumab).

The ECLIPSE study was a phase 3 trial comparing an IL-23p19 inhibitor, guselkumab, to an IL-17A inhibitor, secukinumab. Patients were randomized to receive either guselkumab (100 mg at weeks 0 and 4 then every 8 weeks) or secukinumab (300 mg at weeks 0, 1, 2, 3, and 4, and then every 4 weeks). The primary endpoint was the 90% reduction or more from baseline of Psoriasis Area and Severity Index (PASI 90 response) at week 48.

A total of 1048 patients were enrolled and the PASI 90 response at week 48 was:

• 84% in the guselkumab group
• 70% in the secukinumab group (p<0·0001)
• Non-inferiority was established for other secondary endpoints 

Guselkumab is one of three IL-23 inhibitors approved for use in psoriasis.